CORRESPONDING AUTHOR: KALAKHY YOUNES, ORAL SURGERY DEPARTMENT, TARGA DENTAL CLINIC, MARRAKECH CITY KINGDOM OF MOROCCO.
PUBLISHED: MARCH 25, 20222
© ALL RIGHTS ARE RESERVED BY KALAKHY YOUNES.
Abstract
The accidental opening of the sinus cavity to the oral cavity is not uncommon during tooth extraction, a tumor process, ballistic trauma or any intervention in the posterior maxillary sector, considered a real oral emergency. where the management of closing this breach between the sinus and the oral cavity is necessary in order to avoid the risk of sinusitis with all its complications by passage of germs from the oral cavity to the sinus. The diagnostic process is based on clinical and radiological examination to identify and confirm communication on the one hand and measure the extent of the breach and assess bone resorption in order to indicate the appropriate treatment protocol.
Therapeutic management is based on the principle of closing the gap between the oral compartment and the sinus compartment, several solutions can be undertaken depending on the degree of communication and bone loss, among the reliable tools in the hands of the surgeon is the displacement the buccal fat pad to close the gap.
The aim of this paper is to present two clinical cases about oro antral communication treated by a buccal fat pad flap.
Keywords: Oro Antral Communication; Oral Fistulae; Buccal Fat Pad; Sinus
Abbreviations
BFP: Buccal Fat Pad; OAC: Oro-Antral Communication
Introduction
The oro-antral communication (OAC) is an unnatural communication between oral cavity and the sinus, the main reason of this cases in the upper posterior aeria is the anatomical proximity between upper premolar and molar roots with the sinus floor and sometimes we find the roots projected into the sinus cavity.
Now the question is how to manage this complication?
The first procedure is to check the OAC dimension, generally the defect which are smaller than 2mm can be heal spontaneously by the blood clot, however in the large bone defect cases more than 4mm, the early management of the opening the sinus cavity to the oral cavity should be undertaken because sinusitis presents the major complication according to several authors as wasmmund (60%), on the other hand when the communication has not closed and healed spontaneously, an fistulae is formed and it’s a epithelialization of mucosae, generally this epithelialization usually occurs when the perforation persists for at least 48 – 72 hours.
The principal of the management by the practitioner is the closure of the OAC, basically variable therapeutic modalities have been described in scientific literature in order to manage OAC cases as coronally advanced flap, bone graft, PRF, Implant; among all this tools the clinician could use the buccal fat pad.
